应用分子靶向治疗的时机选择

分子靶向药物的出现显示出肿瘤治疗传统模式的重要进展。与传统放疗、化疗相比,分子靶向治疗因其特异性高、不良反应轻微,在恶性肿瘤个体化治疗中扮演重要角色。十五年来,分子靶向药物的出现,给肿瘤的治疗模式带来重大改变,也给临床医生带来新的挑战。准确把握分子靶向药物应用时机,获得最大临床效果,已成为肿瘤治疗领域关注热点。本文就非小细胞肺癌、消化系统肿瘤、乳腺癌、肾癌治疗中分子靶向药物如何选择应用时机进行阐述。     

医学影像学见习应用PACS教学法与传统读片教学法的对比研究

将中南大学湘雅医学院2010级临床医学五年制197名学生随机分成两组,在医学影像学见习教学过程中分别应用影像存储及传输系统（PACS）教学法（98人）及传统读片教学法（99人）,学期结束时对两组学生考试成绩进行分析,并对PACS组学生进行问卷调查及结果分析.统计数据显示,PACS组学生读片测验及卷面考试中,病例分析题成绩显著高于传统读片组,问卷调查显示PACS组学生大多数认可该教学方法.因此,应用PACS教学有助于提高学生的临床分析能力及主动学习的能力,是学生欢迎的教学方式.但对医学影像学基本知识的传授,应用PACS法较传统读片法并无明显优势.     

人工肝支持系统治疗肝衰竭的研究进展

目前肝衰竭发病率和病死率仍然较高,肝衰竭成为威胁患者生命的严重疾病。基于肝脏具有强大再生能力,人工肝支持系统作为一种“过渡”措施,为肝衰竭患者的肝功能恢复赢得时间。人工肝支持系统根据性质不同分为非生物型人工肝、生物型人工肝和混合型人工肝。目前非生物型人工肝已在肝病治疗领域被广泛应用,但生物型及混合型人工肝的临床应用还存在很多问题需要进一步研究和解决。因此本文对人工肝的作用、临床应用现状、存在问题及研究进展进行综述。     

The effect of force-controlled biting on human posture control

Several studies have confirmed the neuromuscular effects of jaw motor activity on the postural stability of humans, but the mechanisms of functional coupling of the craniomandibular system (CMS) with human posture are not yet fully understood. The purpose of our study was, therefore, to investigate whether submaximum biting affects the kinematics of the ankle, knee, and hip joints and the electromyographic (EMG) activity of the leg muscles during bipedal narrow stance and single-leg stance. Twelve healthy young subjects performed force-controlled biting (FB) and non-biting (NB) during bipedal narrow stance and single-leg stance. To investigate the effects of FB on the angles of the hip, knee, and ankle joints, a 3D motion-capture system (Vicon MX) was used. EMG activity was recorded to enable analysis of the coefficient of variation of the muscle co-contraction ratios (CVR) of six pairs of postural muscles. Between FB and NB, no significant differences were found for the mean values of the angles of the ankle, knee, and hip joints, but the standard deviations were significantly reduced during FB. The values of the ranges of motion and the mean angular velocities for the three joints studied revealed significant reduction during FB also. CVR was also significantly reduced during FB for five of the six muscle pairs studied. Although submaximum biting does not change the basic strategy of posture control, it affects neuromuscular co-contraction patterns, resulting in increased kinematic precision.     

Motor imagery ability and internal representation of movement in children with probable developmental coordination disorder

It has been hypothesised that deficits in the functioning of the mirror neuron system (MNS) and internal modelling may contribute to the motor impairments associated with DCD. These processes can be explored behaviourally through motor imagery paradigms. Motor imagery proficiency of children with and without probable DCD (pDCD) was examined using a complex hand rotation task to explore whether motor imagery strategies could be used during more complex tasks. Forty-four boys aged 7–13 years participated, 22 with pDCD (mean = 9.90 years ± 1.57) and 22 controls (mean = 9.68 years ± 1.53). Participants completed the task twice: with and without motor imagery instructions. Stimuli were presented in two rotational axes – palm/back, and eight 45° rotational steps. Both groups showed evidence of following the biomechanical and postural constraints of actual movements. Responses of children with pDCD were slower and less accurate than controls, with group differences increasing alongside task complexity. A greater impact of biomechanical constraints for accuracy was observed in the DCD group. The response characteristics of children with pDCD likely reflects a reduced capacity to mentally manipulate a body schema and reduced visuo-motor processing capabilities. Behaviourally, these processes are linked to MNS and internal modelling function, suggesting deficits in these systems may contribute to the movement difficulties characteristic of DCD.     

Pluralism and values in education in Hungary – changes between 1990 and 2012

Value transmission is a fundamental task of schools. However, the question arises as to how far prevailing political and social conditions shape the functioning of a country or a region’s school system. In other words: what effect do they have on the choice of values to be transmitted at schools? Are there any fundamental social values that are shared by different cultures at different times? Are there values that exist independently of social and political systems? These questions have a special relevance in Eastern and Central European countries like Hungary where political and social changes in the twentieth century had a crucial effect on the set of values that were transmitted by the school system. The aim of this study is to describe how the value transmitting role of the Hungarian school system has changed as a consequence of political transformations in recent decades.     

Impulsive behaviour in interpersonal encounters: Associations with quarrelsomeness and agreeableness

Associations between impulsivity and interpersonal behaviours have rarely been examined, even though impulsivity may disrupt the flow of social interactions. For example, it is unknown to what extent the commonly used Barratt Impulsiveness Scale (BIS‐11) predicts impulsive behaviour in social situations, and how behaving impulsively during interpersonal encounters might influence levels of quarrelsomeness and agreeableness. In this study, 48 healthy working individuals completed the BIS‐11 and recorded their behaviour in social situations using event‐contingent recording. Record forms included items representing quarrelsome, agreeable, and impulsive behaviours. BIS‐11 motor impulsiveness scores predicted impulsive behaviour in social situations. Impulsive behaviour was associated, in different interactions, with both agreeableness and quarrelsomeness. Behaving impulsively in specific interactions was negatively associated with agreeableness in participants with higher BIS‐11 motor impulsiveness and positively associated with agreeableness in participants with lower BIS‐11 motor impulsiveness. Impulsive quarrelsome behaviour may cause interpersonal problems. Impulsive agreeable behaviour may have positive effects in individuals with low trait impulsivity. The idea that there are between‐person differences in the effects of state impulsivity on the flow of social interaction deserves further study.